Pharmaceutical aids for smoking cessation

According to the Clinical Practice Guideline [112],
all patients attempting to quit should be encour-
aged to use one or more effective pharmacother-
apy agents for cessation except in the presence of
special circumstances. These recommendations are
supported by the results ofmore than 100 controlled
trials demonstrating that patients receiving pharma-
cotherapy are approximately twice as likely to re-
main abstinent long-term(greater than 5mo)when
compared to patients receiving placebo (Figure 1.2).
Although one would argue that pharmacotherapy
is costly and might not be a necessary component
of a treatment plan for each patient, it is the most
effective known method for maximizing the odds
of success for any given quit attempt, particularly
when combined with behavioral counseling [112].
Currently, seven marketed agents have an FDA-
approved indication for smoking cessation in the
US: five nicotine replacement therapy (NRT) for-
mulations (nicotine gum, nicotine lozenge, trans-
dermal nicotine patches, nicotine nasal spray, and
nicotine oral inhaler), sustained-release bupropion,
and varenicline tartrate. These are described in brief
below, and summaries of the prescribing informa-
tion for each medication are provided in Table 1.4.